A roadmap for the Murphy administration to increase access to care, keep a lid on price of insurance, reform Medicaid, and put the focus on patients

Dr. Minalkumar Patel

The new year always gives us a feeling of hope for the future — hope that we can improve upon our own lives and those of our families and friends. In 2018, there is hope for New Jersey when it comes to healthcare. As Gov. Murphy takes the reins in Trenton, we have before us a unique opportunity to reshape the future of health are so that it is less expensive and of better quality for consumers.

Better Choices, Better Care NJ — of which I am proud to be a Steering Committee member — was created to engage and educate consumers on exactly the kinds of ideas that could create this new healthcare landscape. After a year of discussion and feedback, we released a 15-point plan aimed at lowering healthcare costs while improving quality.

We strongly believe that the 15 points outlined in our plan — “Moving New Jersey To Affordable, Quality Health Care” — will truly make a difference: that they will serve as a roadmap for the Murphy administration, and as a guide for policymakers and stakeholders across the state. This transition in the halls of Trenton presents New Jersey with the chance to make long-needed changes while also adjusting for shifting winds coming out of Washington. There may be uncertainty over what happens on any given day, but we can still move ahead in a proactive manner to meet those challenges and more.

Fixing Medicaid

Some of the biggest and most important changes we recommend are to Medicaid. This program is critical to the millions of New Jerseyans who rely on it for their health care. At the same time, behavioral health aspects of Medicaid simply no longer match the world in which we live. The fee-for-service model of providing care, where doctors and hospitals charge for quantity of care over quality of care, is no longer a feasible system. It raises costs while hindering quality. It is time to move away from fee-for-service payment methods in behavioral health while moving towards a patient-centered care system.

Under patient-centered care, incentives are provided for health outcomes, versus simply conducting more tests. It is a system that has the potential to save countless dollars, while also creating a better, higher quality experience for consumers. Moreover, we propose moving behavioral health and substance use disorder services to the Medicaid Managed Care Program. This will not only increase access to care but, through greater efficiencies, reduce costs.

State mandate?

While it makes up only a small part of our recommendations, it would be impossible to talk about healthcare in 2018 without mentioning the ACA. Anticipating the possible elimination of the individual mandate, we propose that the state now look into creating its own mandate. While this provision of the ACA was not without controversy, the fact remains that without the individual mandate, premiums will skyrocket as low-risk individuals fail to join the market. We cannot allow this to happen. At the same time, we recognize the potential impact this could have on the small-business community, and have recommended an impact study be done before any implementation occurs.

In addition to these issues we also talk about having transparency guidelines across all sectors and facets of healthcare, especially when it comes to consumer pricing. We recommend eliminating paper requirements that cost millions of dollars a year. This could be easily fixed by bringing us into the 21st century and giving consumers the option of getting documentation online, versus by paper. We also call for doing away with self-policing healthcare-related state boards by ensuring half of the board consists of consumer representatives.

Our roadmap for lower cost, higher quality healthcare can be viewed at www.betterchoicesbettercarenj.com. We look forward to working with business, labor, and healthcare leaders on these endeavors. 2018 presents us with a great chance to create real change for New Jersey consumers. Let’s not squander that chance.

Dr. Minalkumar Patel, a member of Better Choices, Better Care NJ’s Steering Committee, is a serial physician entrepreneur who recently founded ABACUS Insights to serve payer needs around data integration and insight generation.